Protecting your skin from the cold

For patients with Raynaud’s phenomenon in Systemic Sclerosis

 Many patients with systemic sclerosis and other rheumatologic disorders have Raynaud’s phenomenon, leading to painful hands and feet with cold exposure.  We provide tips on keeping your hands warm to minimize your Raynaud’s phenomenon attacks.

 1. Keep track of your attacks

As a general principle, we think it is important to try and minimize your Raynaud’s phenomenon attacks.  We think at a minimum this will help reduce the number and severity of digital ulcers you may get on your fingers and elsewhere and at a maximum may help lessen the severity of other internal organ involvement (although this not been formally documented in studies).  It can be helpful to keep a journal of the timing, frequency and length of your attacks.  This information can give you some insights on what may trigger your Raynaud’s phenomenon and therefore what you need to avoid.

2. Dress in layers

The first step in reducing Raynaud’s phenomenon is to try and keep your body core warm to minimize  attacks.  It is important to keep your whole body warm (not just your fingers).  It is helpful to dress in layers.  Layers to consider investing in include thermal long underwear, fleece vests and jackets, and hats to keep heat from escaping from your head.

3. Wear mittens

Mittens are better at keeping your fingers warm than gloves.  Mittens also help prevent you from overusing your fingers and give them a rest.  You need your fingers for many things, but without realizing it you may overdo it and injure them.  Finally, it can be helpful to add some additional heat in the form of chemically activated (or microwavable) pouches.  Be careful you do not burn your fingers.   The Heat Factory is an online store that sells a glove-mitten hybrid with the heating pouch over the fingers (as opposed to the ones that fit in your palm).

4. Plan ahead

One of the most common triggers is cold temperature, therefore special measures to keep warm are important when you know you will be going to a cold place (outside when it’s cold, the freezer aisle at the grocery store, doctor’s offices).  Strategies to keep warm are important to be aware of and to incorporate into your daily life.

5. Quit smoking

Smoking cause blood vessel tightening, which worsens Raynaud’s phenomenon.

6. Go for decaf

Avoid caffeine, which can also cause your blood vessels to constrict.

7. Avoid certain medications

There are some medications you should avoid because they can exacerbate Raynaud’s phenomenon.  These include some cold medications, migraine headache medications and beta-blockers, such as propranolol.

8. Use your heater

In the state of California, you get a discount on heating your home to 68 degrees and above if you have Raynaud’s phenomenon.  Find out if this is an option in your state.  Investing in a space heater may also be helpful to you.    Sometimes getting into and out of the shower will trigger an attack and so try to heat the bathroom a bit more during showers.

9. Look for color changes

In addition, while we use the words “cold” and “warm,” you may not sense cold and warm in the same way.  A number of patients in the midst of a Raynaud’s attack do not feel their hands as cold per se (this may be your “normal”).  Your thermostat may be off or injured in some way, and so a better approach is to not let your fingers turn “white” or “blue” for an extended period of time regardless of whether they feel cold or not.  Biofeedback can be helpful for some patients.